Older adults with spinal cord injuries are less likely than younger patients to regain independence in daily life. This is true even though their basic neurological recovery appears similar, according to a new study published December 23, 2025.
The research was published in Neurology, the medical journal of the American Academy of Neurology. The study examined how age influences recovery after a spinal cord injury.
Researchers found that age does not limit recovery of strength or sensation. However, it does affect how well people regain functional abilities needed for everyday living.
As populations grow older and medical care improves, more people are living with spinal cord injuries. The average age at the time of injury is also rising. Despite advances in surgery and treatment, recovery rates have remained largely unchanged for decades.
“Despite substantial advances in medicine and surgery over the past decades, the rate of recovery after spinal cord injury has remained the same,” said lead author Chiara Pavese, MD, PhD. Pavese is with the University of Pavia. She said the findings may help researchers design treatments tailored to a patient’s age.
The study included 2,171 patients with an average age of 47. All were admitted to spinal care units that take part in the European Multicenter Study about Spinal Cord Injury. Participants were followed for one year after their injuries and tested regularly.
Researchers found no link between age and neurological outcomes. Older and younger patients recovered similarly in upper and lower body strength. Sensory recovery, including the ability to feel light touch or pinpricks, was also similar.
Functional recovery showed a different pattern. Older patients had more difficulty regaining independence. This included tasks such as feeding themselves, bathing, managing bladder and bowel function, and moving around.
Walking ability also improved less in older patients. This included how quickly they could walk short distances. The results were the same whether or not they used assistance such as a cane.
Researchers measured independence using a scale from zero to 100. Higher scores reflect better daily function. Patients averaged 31 points when they entered spinal care. After one year, the average rose to 35.
The study found that every additional decade of age was linked to a 4.3-point reduction in recovery on this test. Older patients showed less improvement across all walking assessments.
The decline was most pronounced in people over age 70. This group showed a noticeable drop in functional recovery compared with younger participants.
“People older than 70 need specific approaches to rehabilitation,” Pavese said. She explained that treatment should account for conditions such as heart disease, diabetes, or osteoporosis. Rehabilitation should also focus on skills that directly support daily life.
The results remained consistent after accounting for injury type and severity.
Researchers noted limitations in the study. Many participants were no longer included at the one-year follow-up. There was limited information on whether they dropped out or died. Those missing participants may have differed from those who remained, which could affect the findings.
The study was supported by several organizations. These included the Swiss National Science Foundation and Wings for Life Research Foundation. Funding also came from the European Union’s Horizon 2020 program, the Swiss State Secretariat for Education, Research and Innovation, and the Italian Ministry of Health.
Researchers say the findings highlight a growing need for age-specific rehabilitation strategies. This need is expected to increase as more older adults live with spinal cord injuries.